Mental Health in the Workplace: Accommodations and Workplace Practices to Support Mental Health and Wellbeing

By Krystal Tanner and Andrew Johnson

As of 2021, 76% of U.S. workers reported at least one symptom of a mental health condition, with the World Health Organization estimating by 2030 mental health will be the “leading cause of disease burden globally.” As increasing populations look for workplaces that support mental health, employers are facing an ever-growing demand to develop tools and provide resources to serve the needs of all employees, especially those with mental health conditions.

The Americans with Disabilities Act defines disability as a “physical or mental impairment that substantially limits one or more life activity.” Individuals with mental health conditions meeting this criterion qualify for ADA workplace rights. The ADA Amendments Act of 2008 extends existing legal protections to those with physical and psychological disabilities, prohibiting employment discrimination and providing two distinct rights: the right to privacy and the right to reasonable job accommodations.

The right to reasonable job accommodations ensures that workers with disabilities have access to the necessary tools to conduct their jobs and have equal access to opportunity. In addition to reasonable job accommodations, there is a growing understanding of the role that the physical, cultural and social work environment plays in whether workers can successfully function in the workplace.

Universal Design’s Role in Workplace Accommodations

Through universal design, employers structure their work environment to support all employees, including those with and without disabilities. Modifying and improving the work environment not only enhances employee experience, but also workplace inclusivity and productivity. Universal design as defined by the Department of Labor is “making products, environments, systems and services usable to as many people as possible.” Focusing on flexibility, simplicity and efficiency, universal design works to increase productivity of work environments, while simultaneously increasing inclusivity. Taking into account a variety of abilities, individual needs and lifestyles, universal design utilizes seven principles to approach the work environment wholistically and create environments accessible to all people.

One of the seven principles, equitable use, focuses on ensuring policies, tools and resources are both “useful and marketable to individuals with diverse abilities.” Planning and producing equitable use within the work environment demonstrates support, connection and growth among workers. To create equitable use in the workplace, examples of potential accommodations include providing ergonomic furniture, access to health care and/or support programs, as well as offering various forms of staff training and communication technology.

Another universal design principle is flexibility in use, characterized by the idea of accommodating a “wide range of individual preferences and abilities” in the workplace. Providing flexibility increases the mental wellbeing of employees by decreasing symptoms of depression, burnout, distress and fatigue. Furthermore, when an employee’s mental health improves, work satisfaction increases. Workplace flexibility accommodations can vary from dress code to work schedules — including telework options, medical leave and/or flexible work hours — as well as order of task completion.

While accommodations can function on their own, utilizing universal design in accommodation practices allows employers to shift from reactive workplace actions to creating proactive policies, where equity, inclusion and accessibility become focal points in the work environment. Such a shift enables employers to retain a competitive workforce, in turn, boosting profits, market availability and success.

The Cost and Benefits for Employers

Employers play an essential role in establishing a psychologically safe work environment through implementation of policies and practices that foster diversity, equity and inclusion. According to the American Psychological Association, the estimated cost of job stress nationwide amounts to a $187 billion loss in profits, with 70% to 90% of costs resulting from declined productivity. Businesses, employers and employees all suffer when psychological well-being declines, with losses seen through absenteeism, higher turnover rates, reduced engagement and commitment.

“Basic employee care” is a rising expectation, and the work environment proves to be an “optimal setting” to provide such support through policies, communication networks and team support. While supporting employee well-being can require funds and organization, the benefits can outweigh potential costs and challenges. Moreover, accommodations often incur little or no cost to the employer. A study conducted by the Job Accommodation Network found that out of 720 participating employers, accommodations cost nothing for nearly half the participants. Of those reporting any expense, the vast majority indicated it was only a one-time cost with a median expenditure of $300.

Taking steps toward creating a psychologically safe workplace is a bottom-up approach, with small practices and policies creating the basis for gradual, large-scale changes. Results such as increased productivity, retained talent and reduced turnover can be seen when cost-friendly, minimal accommodations are implemented.

How Does Government Play a Role?

Federal, state and local governments can support employee mental health and wellbeing both through policies relating to workplaces in their jurisdictions, but also through their own employment practices as public sector employers. As attention is drawn to the importance of mental health in the workplace, policymakers are exploring a variety of solutions to support employee mental wellbeing, notably through reasonable accommodations.

Beginning in 2022, the Department of Labor’s State Exchange on Employment & Disability (SEED) hosted a task force on workforce mental health policy. The group, Mental Health Matters: National Task Force on Workforce Mental Health Policy, gathered state policymakers from across the country to review research and policy opportunities to improve employment outcomes for people with mental health challenges. One area of emphasis for the task force was workplace care and supports, which includes incentivizing behaviorally healthy workplaces and broadening infrastructure to educate and promote reasonable accommodations. The report highlights telework and customized workspaces for employees, noting policies in Connecticut, Maine and New Jersey that allow telework opportunities for state employees.

State policies expanding reasonable accommodations to state employees highlight a state’s ability to increase representation of, and support for, employees with disabilities through “state as a model employer” policies and practices. “State as a model employer” is a framework of policy options states can use to create a more inclusive public sector workforce, including those with mental health conditions. Through these policies, states can demonstrate to private employers the economic and organizational benefits of employing people with disabilities.

A variety of states are incorporating accommodations in their employment practices. Tennessee, for example, provides 36 hours of yearly leave for a state employee who is a veteran with a service-connected disability. Minnesota established a centralized accommodation fund, which reimburses state agencies for expenses related to reasonable accommodations for current employees and prospective employees in the hiring process. Policies like these can help address accommodations for individuals with mental health conditions.

Supporting Mental Health for Workplace Success

Addressing mental health in the work environment is about ensuring equal opportunity, accessibility and inclusion. Individuals, employers and policymakers play a role in setting up systems and practices for employee success. Accommodations and universal workplace practices grounded in universal design can create a foundation for employee mental wellbeing, which can help improve productivity and increase employee recruitment and retention.

RETAIN Kentucky is funded by the U.S. Department of Labor and the Social Security Administration under a grant award of $21,600,000 to the Kentucky Office of Employment and Training that will be incrementally provided. 100% of grant funding is from U.S. Federal funds. This document does not necessarily reflect the views or policies of the U.S. Department of Labor or the Social Security Administration, nor does mention of trade names, commercial products, or organizations imply endorsement by the U.S. Government.